@article{0cdfc12b-12a5-4083-8f0c-907e0c12c805,
  abstract     = {{<p>Introduction: Early and risky sexual behaviours among adolescents contribute to adverse health outcomes, yet evidence from school-based settings in India, particularly from methodologically robust samples, remains limited. Previous research in India has documented sexual attitudes and behaviours in specific contexts; however, to our knowledge, no study has examined both risk and protective factors using a large, systematically sampled cohort at the state level. This study investigated sexual activity among school-going adolescents and examined associated risk and protective factors to inform targeted interventions. Methods: A school-based cross-sectional survey was conducted during December 2023 in 204 government schools across Himachal Pradesh, India among 7,563 adolescents aged 13–17 years using a self-administered questionnaire adapted from the Global School-based Student Health Survey in India. Descriptive statistics and multivariate logistic regression were performed to assess predictors of ever having sex, early sexual debut, and non-use of contraception. Results: Overall, 6% of adolescents reported ever having sexual intercourse; of these, 62.4% initiated intercourse before age 14. Fewer than half used contraception. Being a boy, parental employment in unskilled/semi-skilled jobs, substance use, poor mental health, and experiencing bullying were significantly associated with sexual activity. Younger adolescents from larger families had higher odds of early sexual debut. Non-use of contraception was associated with being boy, older age, larger families, experiencing bullying, and mental health problems. Conclusions: The findings underscore the need to strengthen comprehensive, age-appropriate sexual and reproductive health interventions in schools to address early and risky sexual behaviours. Although elements of comprehensive sexuality education are delivered through existing platforms, a structured and systematic approach is lacking. Leveraging ongoing initiatives such as Rashtriya Kishor Swasthya Karyakram and the Ayushman Bharat School Health Programme provides a practical opportunity to institutionalize and scale up integrated delivery within the school system.</p>}},
  author       = {{Mohanty, Saroj and Mehra, Devika and Das, Subha Sankar and Patel, Nikita and Sethi, Gaurav and Garg, Rishi and Gupta, Anmol and Chauhan, Anjali and Mehra, Sunil}},
  issn         = {{3005-0774}},
  keywords     = {{Adolescents; India; Protective factors; Risk factors; School-based survey; Sexual behaviour}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Discover Public Health}},
  title        = {{Sexual activity among school-going adolescents in Himachal Pradesh, India : what are the risky and protective factors?}},
  url          = {{http://dx.doi.org/10.1186/s12982-026-02296-0}},
  doi          = {{10.1186/s12982-026-02296-0}},
  volume       = {{23}},
  year         = {{2026}},
}